Overview

When Peter Gooch needed to train clinicians on the new version of RiO, an electronic patient records system, he faced a quandary. The system would give their productivity a real boost… but getting people trained on the system would mean taking each one away from patient care.

With the N3 WebEx web conferencing system, he had an alternative to traditional face-to-face training sessions. Peter was able to record a single training session and deliver it direct to each clinician’s inbox, so they could view it at their leisure.

The result is that everyone has benefited from RiO more quickly, with no wasted time, and for £50,000 less than it would have cost to deliver the training in person.

A quick refresher session takes 30 minutes to an hour, but previously our clinicians would have lost half-a-day. Now that’s extra time they can spend on patient care.”- Peter Gooch, Associate Director of ICT, Camden & Islington NHS Foundation Trust

Challenge

Training is vital in healthcare. Clinicians and medical staff must be kept abreast of the latest procedures, technological advances, and best practices to be able to deliver the best possible patient care. However, while it’s essential, traditional ways of providing training are costly.

The Camden and Islington National Health Service (NHS) Foundation Trust provides mental health, social care and substance misuse services to a population of 420,000 people in London. Training was formerly carried out in-person face-to-face with small groups of attendees at a central location; a system that had several drawbacks. As well as the large cost of room hire, the training had to be scheduled around each attendee’s commitments. This meant there could be significant delays (typically of around a couple of weeks) between the point at which a training need was identified and the point at which training could be delivered.

The introduction of new functional enhancements of CSE Healthcare’s RiO electronic patient record system, implemented by BT, meant there was a need to train most of the Trust’s 1,800 clinical staff, but the ability to deliver it was constrained by the number of trainers available. Peter Gooch, associate director of ICT at Camden & Islington NHS Foundation Trust, says: “While RiO is not a complex system, we only had two trainers. To deliver the maximum benefit from the functionality it was important to make sure all the clinicians in the organisation knew how to work with it.”

The training would have meant taking all clinicians away from their work at any of the 40 or so sites around North London for a half-day to attend a course at St. Pancras Hospital. Furthermore, the lack of trainers would have extended the training over a protracted period. The challenge was to deliver the training in a quicker and more cost effective fashion.

Solution

RiO is an electronic records system that supports the entire patient journey, from admission to care delivery and discharge. As such, the implementation of functional enhancements to the system at Camden and Islington was expected to yield a wide range of benefits, from improving productivity to enhancing co-ordination between clinicians and between the Trust and other healthcare bodies.

To accelerate the time to achieve benefits from the RiO system it was decided to use conferencing technology over N31, the national broadband network linking hospitals, medical centres and GPs in England and Scotland, to conduct the training. N3 offers two types of conferencing systems: MeetMe for audio-only meetings and N3 WebEx for fully-featured online video conferencing. These were both used to deliver the RiO training; MeetMe provided audio-conferencing while N3 WebEx enabled file sharing.

N3 WebEx enables collaborative working on documents, presentations and other electronic materials while maintaining the security of patient-sensitive data. N3 WebEx can also be used to view low-resolution scans and pathology information, and video presentations. Using the latter, the Trust was able to deliver live and pre-recorded video training packages direct to clinicians’ desktops for viewing at any time.

Not only that, but N3 WebEx is also being used routinely at the Trust for a wide range of other applications, from clinician-to-clinician consultations to virtual meetings between the ICT department and its suppliers.

[1] N3 Service Provider is managed by BT on behalf of NHS Connecting for Health

Value

N3 WebEx has enabled the Trust to improve the speed and cost-effectiveness not just of its RiO implementation but also of almost any training-related project. “By using N3 WebEx rather than traditional approaches, we are saving at least £50 per user, which equates to about £10,000 over the life of the deployment project,” Peter Gooch says. “It’s very easy to get a return on the investment, and we’ve already got payback two or three times over.”

That saving of at least £50 comes from the fact that staff no longer have to take time out of their schedules to travel to the training location, a process that could add a couple of hours to the duration of a one-hour session.

The Trust has also been able to take advantage of the full benefits of RiO, which include:

E-prescribing, where prescriptions are printed rather than handwritten, leading to a consistent approach, instant access to medication side effects and contra indications, easier reading, and a clear audit trail of prescribed medicines.

Enhanced letter production feature, enabling access to more letter templates, which allows comprehensive correspondence such as discharge summaries to be produced directly.

Support for recent amendments to the Mental Health Act, with the functionality to create Community Treatment Orders and run associated reports.

Besides one-off programmes such as RiO, N3 WebEx saves time and money for the 60 to 150 medics who join the Trust every year and require induction or revalidation training. Instead of having to wait for a suitable half-day window for an in-person session, consultants can undertake the training modules at their desks and get on with seeing patients straight away. The Trust estimates this saves around £30,000 a year. Says Peter Gooch: “Before it would have taken a couple of weeks, but now our doctors can do the revalidation session there and then. We are saving a huge amount of clinical time.”

There are further financial savings because N3 WebEx effectively allows the Trust to have one trainer provide training to multiple locations at the same time. Since starting to use the technology, Peter Gooch lost one member of his two-person training team. He has not had to seek a replacement, even though the training requirements have increased. “We are saving £40,000 to £50,000 a year by not having an additional trainer,” he says.

In addition, N3 WebEx is helping clinicians be more productive by removing the need for travel to training courses and giving them a tool with which to hold virtual meetings with each other and with patients. Peter Gooch adds: “We have put in a bid for fifteen Productive Ward screens so we can hold ward round debriefs by N3 WebEx, so if clinicians are away from the workplace they can still join the meeting.”

N3 WebEx has since been used to impart training on Docman, an electronic patient discharge system, which had to be delivered to 200 clinicians and GPs. Carrying out the training over the web saved around 80 clinician-days plus travel expenses, or the equivalent of around £10,000. “We would not have been able to implement the Docman solution without N3 WebEx,” concludes Peter Gooch.